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Preventing Firearm Violence: A Public Health Imperative
- American College of Physicians
- This paper was authored by Bobbie Lewis, MA, and was developed for the 1993-1994 Health and Public Policy Committee: Gerald E. Thomson, MD, Chair; Whitney Addington, MD; Robert A. Berenson, MD; Christine K. Cassel, MD; Nancy E. Gary, MD; Sheldon Greenfield, MD; David J. Gullen, MD; Charles E. Harrison Jr., MD; L. Julian Haywood, MD; Ana Maria Lopez, MD; Ernest L. Mazzaferri, MD; Mack V. Traynor Jr., MD; and James R. Webster Jr., MD. Approved by the Board of Regents on 21 November 1993. Requests for Reprints: Linda Johnson White, Director, American College of Physicians, Independence Mall West, Sixth Street at Race, Philadelphia, PA 19106-1572.
Firearm-related injuries in the United States have reached epidemic proportions. The level of firearm morbidity and mortality sustained here is far higher than anywhere else in the industrialized world. More than 38 000 Americans died because of firearm-related injuries in 1991 [1]. More than half of all homicides and suicides are committed with firearms [2]. Firearms are the leading cause of death in black men 15 to 34 years of age and are surpassed only by motor vehicles as the leading cause of all U.S. injury-related deaths [2].
Physicians and other health professionals have the opportunity to bring their knowledge and experience to bear in addressing this pervasive problem. The prevention of violence by public health methods is as much a responsibility for physicians as is the treatment of its victims [3]. Injury control strategies have successfully led to measurable reduction in morbidity and mortality related to other public health problems, such as motor vehicle accidents. Efforts to produce similar results in the area of firearm injuries can and should be taken.
Background
It is estimated that approximately 200 million firearms are privately owned in the United States (U.S. Bureau of Alcohol, Tobacco, and Firearms, 1991). Half of all U.S. households contain firearms, and one in four contains a handgun [4]. Many people report protection from crime as their single most important reason for keeping a gun in the home [5]. Evidence suggests, however, that a gun kept in the home is far more likely to be used to kill a family member than an intruder [6]. Indeed, most victims of homicide are not killed during the commission of another crime but during the course of an argument, often by persons they know [7]. More than 17 000 murders were committed with firearms …
